The present invention refers to a semi-rigid compressive clamp designed for use in the heart-surgery field for osteosynthesis following on sternotomy. The invention moreover refers to a forceps for the application of said clamp.
As is well known to those skilled in the sector, at present one of the systems most widely used for osteosynthesis following on sternotomy involves the use of steel wires, which are made to pass at the rear of the sternum and are tied at the front. However, the use of steel wires gives rise to a number of serious problems as described below. Following upon mobilization of the patient after sternotomy has been carried out, it frequently happens that the steel wires are not able to guarantee optimal osteosynthesis. This is due to the fact that muscular tension during dilation of the thoracic cage (even simply on account of respiratory movements) causes a slight diastasis of the sternal segments, which the steel wire is unable to correct since it is not elastic. There thus remains a certain laxity of the osteosynthesis.
The looseness of grip of the steel wire, which occurs following upon mobilization, above all in patients who are at risk, may cause displacement of the closing knot. The knot itself in these cases causes decubitus of the soft tissue overlying the sternum.
Furthermore, the use of steel wires generally causes a considerable lysis of the bone on the sternal margin.
Another drawback is due to the fact that the point of tying of the steel wires at the front of the sternum may remain slightly raised with respect to the plane of the bone.
In addition, the steel wires for sternal synthesis must be removed before any instrumental investigations, such as x-rays or CAT imaging, are carried out in so far as the wires prevent visualization of the underlying structures.